Streamline the dry eye clinic by following these steps

Considering what is involved with the diagnostic testing and follow-up evaluations of our dry eye disease (DED) patients, ideas for streamlining the DED clinic are welcomed. I feel I can speak on this, as for the last almost-10 years I saw these patients in a medical-only, referral practice that was a well-oiled machine. Recently, I transitioned to a smaller practice that performs a lot of medical care, but the basic principles of how to implement DED diagnosis and treatment efficiently are the same.

SET PROTOCOLS

From the front desk to the doctor’s chair, optometrists can help streamline the dry eye clinic by developing protocols.

For example, ODs can instruct front-desk staff to listen for buzz words, such as “burning,” from possible DED patients making appointments. This way, front-desk staff can place these patients in a slot deemed for a DED evaluation.

Additionally, optometrists can have staff utilize texting and email services to send out a DED questionnaire to the patient before the appointment. This example also provides further efficiency in that the technicians can use the questionnaire to indicate when to perform dedicated DED diagnostic testing, such as tear osmolarity and meibography, during the work up.

USE THE SLIT LAMP

I, among many of my colleagues, value the available and ever-evolving DED diagnostic devices. They provide more detail of the patient’s condition, and aid us in creating the best treatment plan and management schedule. At the very least, a slit lamp exam with vital dyes should be performed since we know it yields valuable information, without adding a significant amount of chair time. Depending on findings, it may indicate a follow-up appointment should be made for the full battery of DED diagnostic tests. Pro Tip: Don’t forget the lids — look, lift, push, pull.

How busy the optometrist’s office is, the flow, and the number of staff members determine when best to implement ancillary testing and treatments. Currently, as my new practice is growing, I have specific days in the week blocked for DED ancillary testing and in-office treatments.

ACQUIRE VISION AND MEDICAL INSURANCE INFORMATION

When the patient calls to make an appointment, the OD should consider having front-desk staff ask the patient for both their vision and medical insurance. The reason: Regularly, ODs note medical problems, such as DED, in patients who present for their “routine” eye exam.

Depending on the chronic condition’s severity and its effect on the patient’s refraction, the exam may fall under medical, requiring the patient’s medical insurance information. Having it to begin with saves time.

IT CAN BE DONE

With a protocol in place for triaging and seeing these patients, utilizing the slit lamp, and acquiring both vision and medical insurance from the patient from the start ­— coupled with a good patient discussion — it is, indeed, possible to see DED patients efficiently. A goal without a plan is just a wish, so put pen to paper and create your office protocols to enhance your patients’ DED experience. OM

DR. KOETTING practices at Hines-Sight in Denver, Colo. She is a fellow of the American Academy of Optometry, diplomate of the American Board of Optometry, an active member of AOA, and a speaker and consultant for multiple companies. Follow her on Instagram at Dr_Jazz_Hands, or email her at Dr.CeceliaKoetting@gmail.com.